BACKGROUND Traditionally Type 2 Diabetes Mellitus (T2DM) was associated with older age, but is now being increasingly diagnosed in younger populations due to the increasing prevalence of obesity and inactivity. We aimed to evaluate whether a tool developed for community use to identify adolescents at high lifetime risk of developing T2DM agreed with a risk assessment conducted by a clinician using data collected from five European countries. We also assessed whether the tool could be simplified. METHODS To evaluate the tool we collected data from 636 adolescents aged 12-14 years from five European countries. Each participant's data were then assessed by two clinicians independently, who judged each participant to be at either low or high risk of developing T2DM in their lifetime. This was used as the gold standard to which the tool was evaluated and refined. RESULTS The refined tool categorised adolescents at high risk if they were overweight/obese and had at least one other risk factor (High waist circumference, family history of diabetes, parental obesity, not breast fed, high sugar intake, high screen time, low physical activity and low fruit and vegetable intake). Of those found to be at high risk by the clinicians, 93% were also deemed high risk by the tool. The specificity shows that 67% of those deemed at low risk by the clinicians were also found to be a low risk by the tool. CONCLUSIONS We have evaluated a tool for identifying adolescents with risk factors associated with the development of T2DM in the future. Future work to externally validate the tool using prospective data including T2DM incidence is required.

中文翻译：

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评估和完善PRESTARt工具，以与临床医师进行风险评估相比，确定12-14岁处于发展为2型糖尿病的终生高风险人群中：一项横断面研究。

背景技术传统上，2型糖尿病（T2DM）与年龄较大有关，但由于肥胖和不活动的患病率日益增加，现在正越来越多地在年轻人群中进行诊断。我们旨在评估一种为社区使用而开发的工具，以识别具有发展为T2DM的高终生风险的青少年的方法是否与临床医生使用从五个欧洲国家收集的数据进行的风险评估相一致。我们还评估了该工具是否可以简化。方法为了评估该工具，我们收集了来自五个欧洲国家的636名12-14岁青少年的数据。然后由两名临床医生分别评估每个参与者的数据，他们判断每个参与者在一生中罹患T2DM的风险较低或较高。这被用作对该工具进行评估和完善的金标准。结果精致的工具将超重/肥胖和至少其他危险因素的青少年分类为高风险（高腰围，糖尿病家族史，父母肥胖，未哺乳，高糖摄入，高筛查时间，体力低下）活动和水果和蔬菜摄入量偏低）。在临床医生发现的高风险患者中，有93％也被该工具视为高风险。特异性表明，在临床医生认为处于低风险的患者中，有67％也被该工具发现为低风险。结论我们评估了一种工具，用于识别具有与将来T2DM的发展相关的危险因素的青少年。